| Mr Michael Anthony Black, MS | |
|
230 Main Street Ext, Middletown, CT 06457-4470 | |
| (860) 343-5303 | |
| (860) 344-3339 |
| Full Name | Mr Michael Anthony Black |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 230 Main Street Ext, Middletown, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437703873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Entity Name | Gilead Community Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518948025 PECOS PAC ID: 0244289643 Enrollment ID: O20050112000765 |
| Entity Name | Stokes Counseling Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134541469 PECOS PAC ID: 9638504202 Enrollment ID: O20200109001018 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael Anthony Black, MS 230 Main Street Ext, Middletown, CT 06457-4470 Ph: (860) 343-5303 | Mr Michael Anthony Black, MS 230 Main Street Ext, Middletown, CT 06457-4470 Ph: (860) 343-5303 |
Ms. Jamie Lynn Birchall, AS DARC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1250 Silver St, Middletown, CT 06457 Phone: 860-346-0300 | |
Ashley Lunt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 955 S Main St # B201, Middletown, CT 06457 Phone: 203-533-2351 | |
Nicole Mcminn, MFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 20 Tuttle Pl, Middletown, CT 06457 Phone: 860-632-3235 | |
Mrs. Nicole Marie Alexopoulos, MSAP Counselor Medicare: Not Enrolled in Medicare Practice Location: 1250 Silver St, Middletown, CT 06457 Phone: 860-972-1106 Fax: 860-346-6108 | |
Pamela Mulready, LPC, LADC Counselor Medicare: Medicare Enrolled Practice Location: 850 Randolph Rd, Middletown, CT 06457 Phone: 860-975-5573 | |
Michael Lauro, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 675 Main Street, Middletown, CT 06457 Phone: 860-347-6971 Fax: 860-343-7379 | |
Ashley Ey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 520 Saybrook Rd, Middletown, CT 06457 Phone: 860-740-8132 |